Provider Demographics
NPI:1730543018
Name:BENNETT, JAMES ADAM (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ADAM
Last Name:BENNETT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:J. ADAM
Other - Middle Name:
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4200 S WESTNEDGE AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3208
Mailing Address - Country:US
Mailing Address - Phone:269-459-7821
Mailing Address - Fax:
Practice Address - Street 1:4200 S WESTNEDGE AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3208
Practice Address - Country:US
Practice Address - Phone:269-459-7821
Practice Address - Fax:269-343-4600
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst